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The Great Physician's Rx for High Cholesterol
By Jordan Rubin Joseph Brasco
Thomas NelsonCopyright © 2007 Jordan Rubin
All right reserved.
Chapter OneKEY #1
Eat to Live
Growing up in cosmopolitan Copenhagen in the aftermath of World War II, Uffe Ravnskov set out to become a doctor. His dream was realized at the University of Copenhagen in 1961, when he received his M.D. and began his clinical education in various hospitals in Denmark and Sweden. Dr. Ravnskov was an inquisitive sort who devoted years of research to heart aneurysms, heart attacks, and urinary tract infections. He gathered a reputation as a contrarian who didn't automatically accept the prevailing conventional wisdom: for instance, when his research into the major cause of urinary tract infections in women turned out to be soap, not bacteria, he wasn't afraid to publish a paper in the medical journal saying so.
In the late 1980s, the Swedish equivalent of the American Medical Association began beating the cholesterol drum to warn everyone from Stockholm to Stocksätter about the dangers of eating foods high in dietary fat because of its association with the development of high cholesterol and cardiovascular diseases. By golly, the Swedes were going to do something about the rising number of heart attacks in their country, even if that meant changing the Swedish attitude about eating a Danish in the morning.
At this time, Dr. Ravnskov oversaw a busy practice in southern Sweden. One of his patients was Karen, a cheerful and optimistic sixty-two-year-old woman who cleaned offices in a nearby factory. When Karen made an appointment to see Dr. Ravnskov, he noticed that his formerly chipper patient was tired and depressed, not at all her old self.
Dr. Ravnskov gently inquired why she wasn't feeling well. She replied that two years earlier her company had asked all the employees to participate in a series of health exams, including blood tests. Her cholesterol count came back too high, Karen said. The company doctor informed her that she was a likely candidate to have a heart attack within five years if she didn't change her diet.
Only five years to live! The news shook Karen because she felt fit as a fiddle and was looking forward to an energetic retirement. When she asked what she could do to extend her life, the company doctor directed her to stop eating high-fat foods and turn to a low-fat, high-fiber diet of fruits and vegetables. This advice distressed Karen, who loved to cook and was known in her village as the maker of the best cheesecake north of Amsterdam.
Karen accepted the company doctor's advice, though lifelong habits were hard to break. If she and her husband celebrated a special occasion with a steak, she trimmed off all the fat, even though it was the "tasty and best part," she said. Despite drastically modifying her diet, however, her high cholesterol levels did not budge. After reviewing her chart, the company doctor informed her that she wasn't doing enough. "You need pills," he declared, so he wrote Karen a prescription for cholesterol-reducing drugs.
The medications made her feel even worse. Nausea and physical discomfort would strike within an hour of gulping down the pills. Her appetite disappeared, and she didn't want to eat anything at all. Karen lost weight, but more distressing, she lost her stamina and zest for life.
The combination of diet and drugs did lower her cholesterol some but not enough to satisfy the company dietician, who regarded Karen with great skepticism when she promised that she had been eating right. "That's impossible," the dietician scolded. "You must have eaten more fat than that."
Karen felt terribly guilty because she had enjoyed a piece of her favorite dessert-cheesecake-the night before.
Chances are that if you're dealing with high cholesterol, you feel guilty when you dig into some of your favorite comfort foods. If so, you're not alone. In his book, The Cholesterol Myths, Dr. Ravnskov described the results of a Gallup Poll taken in this country showing that 56 percent of all Americans worry about fat and cholesterol, 45 percent think that the food they like is not good for them, and 36 percent have guilt feelings when they eat the foods they like.
The reason we feel this way is that physicians have a way of putting the fear of God into their patients when it comes to diet, as Karen and Carol Wootten can attest. Doctors will bluntly tell you to lay off barbecued steak, stop eating hamburgers, stay away from deep-dish pizza, shake your salt habit, substitute a margarine spread for butter, and say no to nuts. They will outline a strict diet that puts many of your favorite foods off-limits-no cheese, butter, or other full-fat dairy products-with orders to eat lots of fish, small amounts of lean meat, and plenty of high-fiber fruits and vegetables.
The reason physicians impart this dietary advice stems from an entrenched, widely held belief that has been part of modern medicine for decades: a high-cholesterol diet promotes coronary heart disease, and the best way to prevent heart disease is for patients to restrict their diet to low-fat, high-fiber foods. The diet-heart connection, as it's known in the hallways of our nation's medical schools, has become one of the most deeply ingrained beliefs in modern medicine. The scientific link between high cholesterol levels and cardiovascular disease dates back to a landmark research project called the Framingham Heart Study, which began in 1948 when researchers recruited 5,209 men and women between the ages of thirty and sixty-two from the town of Framingham, Massachusetts.
The objective of the Framingham Heart Study-it's still going strong after nearly sixty years-is to identify the common factors or characteristics that contribute to cardiovascular disease by following its development over a long period of time in a large group of participants who had not yet developed overt symptoms of CVD or suffered a heart attack or stroke. A project of the National Heart, Lung, and Blood Institute, the Framingham Heart Study is on its third generational cohort of participants.
The thousands of Framingham residents who have participated in the study have submitted to extensive physical examinations and lifestyle interviews, which have been analyzed for common patterns related to cardiovascular disease development. In 1961, the Framingham Heart Study announced one of its first major discoveries: cholesterol level abnormalities were found to increase the risk of heart disease. Other research milestones followed: in 1987, high blood cholesterol levels were found to correlate directly with the risk of death in young men; and in 1988, high levels of good HDL cholesterol were found to reduce the risk of death.
One doctor closely following the scientific literature about the latest research coming from the Framingham Heart Study was Dr. Ravnskov, who earned a Ph.D. for his scientific studies at the Departments of Nephrology and Clinical Chemistry at the University Hospital in Lund, Sweden, during the 1970s before starting his private practice.
Remember, Dr. Ravnskov likes to think outside the medical box, and he wasn't convinced that cholesterol hardens arteries while carrying vital oxygen and nutrients to and from the heart. The more Dr. Ravnskov evaluated the Framingham Heart Study and other peer-review studies in top American medical journals, the more he believed that the case against cholesterol was built on circumstantial evidence. From Dr. Ravnskov's viewpoint, the emperor-King Cholesterol-wore no clothes because as best as he could determine, he couldn't find conclusive proof regarding the connection between high cholesterol levels and cardiovascular disease. The Swedish doctor wrote nearly forty medical papers critical of the alleged association between cholesterol and cardiovascular disease.
For instance, he pointed out that in a thirty-year follow-up of the Framingham population, high cholesterol wasn't predictive for a heart attack after the age of forty-seven, and those whose cholesterol went down actually had the biggest risk of having a heart attack! His citation came straight from the Framingham study: "For each 1 mg/dl drop of cholesterol, there was an 11 percent increase [italics added for emphasis] in coronary and total mortality."
Pointing out inconsistencies earned Dr. Ravnskov a reputation in medical circles as a gadfly at best and a rabble rouser at worst. His critical but scientific analysis was of little interest to the editors of the Journal of the American Medical Association (JAMA) or the New England Journal of Medicine (NEJM), or to the mainstream medical community, which continued to advise patients to limit their intake of fats, including those foods rich in saturated fatty acids, to reduce their risk of dying from cardiovascular disease.
Stymied in his attempts to find an audience among his peers, Dr. Ravnskov put down his concerns in the book The Cholesterol Myths, first published in Sweden in 1991-in Swedish. The book was largely ignored and produced little impact. Even worse, critics on a Finnish TV show burned his book on the air! Several years passed, and Dr. Ravnskov thought that having The Cholesterol Myths published in English would jump-start the discussion. Queries to literary agents and publishers in Great Britain and the United States were summarily rejected, however.
Then the Internet arrived on the scene in the latter half of the 1990s. Suddenly Dr. Ravnskov didn't need a publisher; he posted a few chapters of The Cholesterol Myths on the Web, and presto, he was no longer a pariah tilting against windmills, fighting a lost cause as Don Quixote did. As word of mouth built-and people typed in "cholesterol and heart disease" in their search engines-Dr. Ravnskov received e-mails from those impressed with his measured and clear-eyed analysis, including researchers skeptical about the diet-heart connection percolating through the medical community.
One of those who corresponded with Dr. Ravnskov was Sally Fallon, a friend of mine and president of the Weston A. Price Foundation. She, too, had written an against-the-grain book on natural health called Nourishing Traditions, and like the Swedish doctor, she had encountered problems with finding a publisher. Sally eventually started her own publishing company, New Trends, which printed Nourishing Traditions and received strong sales. Because she believed in Dr. Ravnskov's message, she made The Cholesterol Myths one of her first acquisitions.
Dr. Ravnskov's work confirms my suspicion that the oft-recommended low-fat, high-fiber diet touted for preventing high cholesterol will never be the hoped-for panacea. Too many doctors are recommending that people stay away from certain foods that can actually be quite beneficial to overall health.
The so-called high-fat foods-steak, eggs, butter, and dairy products-when consumed from free-range and organic sources, actually contain fats that your body needs for optimal health. God, in His infinite wisdom, created fats to do the following functions: play a vital role in bone health, enhance the immune system, protect the liver from alcohol and other toxins, and guard against harmful microorganisms in the digestive tract.
The best examples of good fats are omega-3 polyunsaturated fats, monounsaturated (omega-9) fatty acids, and healthy saturated fats. Yes, you heard me right: healthy saturated fats. You can find these fats in a wide range of foods, including salmon, lamb, goat meat, goat's and sheep's milk, grass-fed cow's milk and cheese, coconut, flaxseed, walnuts, olives, almonds, and avocados. These fats provide us with a concentrated source of energy and are the source material for cell membranes and various hormones.
Ah, you may ask, "Didn't the Creator know that certain fatty acids are the main causes of coronary disease?"
Yes, He did, but it's the foods with trans fat that push up our cholesterol numbers to unacceptable levels. Trans fats are produced by heating liquid vegetable oils in the presence of hydrogen to make them solid at room temperature-a process known as hydrogenation. Food conglomerates routinely utilize hydrogenated oil in their manufacturing plants, which means that trans fats are found in nearly all our processed foods-foods that God definitely did not create.
I'm talking about vegetable shortening, frozen pizza, ice cream, processed cheese, potato chips, cookie dough, white bread, dinner rolls, snack foods, doughnuts, candy, salad dressing, margarine-the list is endless. Commercially prepared fried foods, like French fries and onion rings fried in polyunsaturated vegetable oils, also contain gobs of trans fat. Why do food producers employ so much chemistry? Because it allows them to produce a more competitively priced product with a longer shelf life.
Trans fat does a number on your cholesterol levels by raising your bad LDL and lowering the good HDL, which elevates the risk of heart disease as well as type 2 diabetes. Scientists have been warning us for years that eating trans fat can lead to high cholesterol and heart problems, which is why in 2006 the US Food and Drug Administration began requiring companies to state the amount of trans fat as part of the nutrition facts.
I'm convinced, however, that if you eat the foods that are part of the Great Physician's prescription for high cholesterol, you can control your cholesterol and get levels down to the healthy range.
Laying the Groundwork
The first key-"Eat to live"-happens to be the most important prescription in The Great Physician's Rx for High Cholesterol because what you choose to nourish yourself with positively or negatively affects your cholesterol levels as well as your overall health. The best way to eat to live can be summed up by these two foundational principles:
1. Eat what God created for food. 2. Eat food in a form that is healthy for the body.
Eating food that God created in a form that is healthy for the body means choosing foods as close to the natural source as possible, which will provide sustenance for your body, keep your cholesterol in check, and give you the healthiest life possible. As you can probably figure out by now, I'm a proponent of natural foods grown organically, since these are foods that God created in a form healthy for the body.
The Encyclopedia of Natural Healing points out that high levels of circulating cholesterol are an attempt by the body to fight free radicals-a clear warning signal to change diet and lifestyle. Free radicals are oxygen molecules with a single electron, but these unstable molecules are known to attack the immune system's cells. Antioxidants neutralize these dangerous free radicals.
The most well-known antioxidants are vitamins E and C and beta-carotene. Through scientific research, we've learned that vitamin E is a fat-soluble vitamin present in nuts, seeds, whole grains, apricots, vegetables, and eggs laid by healthy chickens. Vitamin C, chemically known as ascorbic acid, is a water-soluble vitamin present in green peppers, cabbage, spinach, broccoli, kale, cantaloupe, kiwi, strawberries, and citrus fruits and their juices. Beta-carotene is a precursor to vitamin A (which means the body converts beta-carotene to vitamin A) and is present in butter from grass-fed cows, spinach, carrots, cereal grasses such as wheat and barley, squash, broccoli, yams, tomatoes, cantaloupes, and peaches. These foods contain many other antioxidants and phytonutrient plant compounds that are being continually studied for their amazing health-giving benefits.
Take another look at the foods I just described. Do you think the average person is eating enough of these foods? Does a typical American diet of Pop-Tarts and coffee for breakfast, hamburger and fries for lunch, and spaghetti and meatballs with garlic bread for dinner fit this bill?
Optimizing nutrition begins with an awareness of what you are sending to your digestive tract. To begin with, everything you put into your mouth is a protein, a fat, or a carbohydrate. Let's take a closer look at these macronutrients.
The First Word on Proteins
Proteins, one of the basic components of foods, are the essential building blocks of the body and involved in the function of every living cell, just like cholesterol. One of protein's main functions is to provide specific nutrient material to grow and repair cells.
Excerpted from The Great Physician's Rx for High Cholesterol by Jordan Rubin Joseph Brasco Copyright © 2007 by Jordan Rubin. Excerpted by permission.
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